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The Moi Teaching and Referral University Hospital project is a collaborative effort between Kenneth Chelule of the ISB and Dr. Kibor Lelei, a specialist orthopaedic surgeon at the hospital in Eldoret, Kenya. Their objectives were to set up a gait lab, consisting of a second-hand Motion Analysis Corporation camera system donated by Kenneth Chelule, for clinical and research initiatives to address local issues. Marco Vaz (ISB Executive Council member) helped guide the process of transporting the camera system from the UK to Kenya, before the system was successfully installed by a Motion Analysis Corporation (MAC) representative in January 2010. After receiving specialist training in the equipment by the MAC representative, staffs at Moi University Hospital are now looking forward to collaborating in using the new facility in enhancing patient management and research.

The Moi University Project History

In August 28th 2009 Dr. Kenneth Chelule sent an email to Prof. Kit Vaughan, former ISB President, informing that he “received an old MAC (Motion Analysis Corp) Falcon System for gait analysis given by Leeds University”, which he intended to donate to East Africa. In August 29th 2009, Prof. Vaughan forwarded Dr. Kenneth’s email to Profs. Julie Steele (ISB President) and Darren Stefanyshyn (ISB Newsletter) “to find a worthy home for this equipment”. In August 30th Prof. Julie Steele answered Prof. Chelule’s email and forwarded to Prof. Marco Vaz (ISB Affiliated Societies & Developing Countries Officer) his email to study the possibilities of finding the best place in Africa to create a new gait lab. This is how the Moi Project started.

Since then, Dr. Chelule has become the Moi Project mentor and has taken several actions towards making the new Moi Gait Lab reality. He personally contacted Lucy Keighley, Vice President of Sales (Europe, Middle East and Africa) from Motion Analysis Corporation to check the conditions of the equipment, giving the first push to the project. Dr. Chelule also decided on the Moi Teaching and Referral Hospital (MTRH) to be the recipient to receive the new equipment.

The Moi Teaching and Referral Hospital is located in a rural setting of Western region of Kenya in Eldoret town, Uasin Gishu district, North of Rift Valley province. It is about 320km North West of Nairobi. The hospital is located along the Nandi Road, East of Eldoret town. There are signposts in strategic positions along main roads in the town to guide visitors, clients and patients to the hospital

The Moi Teaching and Referral Hospital was founded in 1988 has second medical school in Kenya. The school started as a Faculty of Health Sciences with 40 students.

Today the School of Medicine has a student population of 800 students with the School of Public Health having about 160 students. Teaching staffs is 107 and the non teaching workforce is 150.

The School has 17 departments and runs 6 postgraduate programs in medicine, child health, Family Medicine, Medical Education, Immunology and Nursing.

The opening of the Faculty of Health Sciences at Moi University was a landmark event that would later have a direct impact on the development of the hospital leading to elevation of the hospital from a provincial to a national teaching and referral hospital (only the second after Kenyatta National Hospital) to serve Western Kenya with its functions being to provide training, educational facilities and participate in National Health Planning.

The college is also a World Health Organisation (WHO) collaborating centre for problem based or problem solving approaches to education and practice in health. The school of medicine uses Moi Teaching and Referral Hospital as its base for research and teaching.

Administration building (Main campus).

Travelling to Kenya:

Fly into Nairobi JKIA airport and take a 45 mins local flight to Eldoret. The route is operated by Jetlink Express and Fly540. Taxi from the Eldoret airport to Moi Teaching and Referral Hospital was £7 plus tip and takes about 20mins. Eldoret or surrounding districts is the breadbasket of Kenya and there is evidence of this as one approaches the city. There is also plenty evidence of a fast growing city.

As the world capital city of long distance running, a visit to local stadia (Eldoret and 64) is highly recommended. Taxi ride within the city is about £3.

Initial ISB Visit to Moi University

On arrival Ken was met by Dr Lelei, the project team leader at Moi University. Dr Lelei was organised for the visit, which included a range of meetings with management, school staff and a tour of the laboratory.

The programme began with a meeting with the director Moi Teaching and Referral Hospital and his deputy, who formally and gracefully thanked all the parties concerned for the donation and for the support in setting up of the gait laboratory.

A guided tour by Mr. D. M. Alliagana (the chief technician), of the new laboratory then followed. The laboratory is housed within the new physiology building. The laboratory is fully set-up but the university has felt necessary that new hardware (laptop) need to be installed before any project is commissioned. The laptop had been purchased and was waiting to be installed.

After the tour, Ken met with the dean of school of medicine Dr. Ayuo. His office has been instrumental in facilitating clearance and in providing necessary resources to set up the new laboratory. He pointed out that the department would provide the project with any support it requires.

NHK TV station members recording proceedings.

The surprise of the day was left to a meeting with the head of physiology department Dr. E. Anjila. At time of the visit, Dr. Anjila was hosting visiting NHK Japanese TV station crew who were at the university to document the new gait lab in town and in the country. This being part of ICEARS (International Centre for East African Running Studies) documentary on Kenyan runner story.

ICEARS was launched by the University of Glasgow in 2004 with the aim of studying the physiological, genetic, psycho-social and economic determinants of the phenomenal success of east African distance runners in international athletics. The project is hosted by Moi University and is currently directed by Dr. Anjila.

Dr. Anjila further informed the meeting that a number of initiatives have been planned for the coming months. These programmes would have the gait machine as partly central in reaching their primary goals. These include

Total joint surgery planned for mid-May 2010. The patient will be pre and post assessed using the gait machine.

Workshop on Biomechanics on the 14th July 2010 by Prof Yannis Pitsiladis of University of Glasgow and Prof Daniel Lieberman of Harvard University. Prof Pitsiladis and Prof Lieberman are key members of ICEARS.

Dr. Anjila revealed that the school was planning to introduce a sport science course. There is also an ongoing discussion with a local shoe and textile manufacturer to explore areas of possible research interest.

The last event was demonstration of the gait machine in operation. Demonstration was performed by Mr. D. M. Alliagana. Mr Meshack Sang, a local athlete kindly accepted to volunteer for this exercise. Ken reckoned that this was an excellent performance by both Mr Alliagana and Mr Sang. Ken was impressed by how quick they had gained command and understanding of the gait machine operation. The attendees or audience included the NHK TV members who used the opportunity to record the proceedings.

ISB Installation of Equipment in Moi University

Gait machine calibration:

Gait machine in operation:

Challenges facing the project

Equipment is yet to be used for routine screening.

Computer programme upgrades may prove a burden in the future

Lack of qualified staff. Both short term and long solutions are required

Responsibility over custody for purposes of facilitating appropriate maintenance needs to be identified. Temporary custody may be given to ICEARS team (sign tripartite MOU between ICEARS, Moi University and ISB) as they have long experience in using this technology.

The establishment of the laboratory was supported in part by a donation of Second-hand 6-camera MAC (Motion Analysis Corp) Falcon System from the Section of Musculoskeletal Disease at the University of Leeds.